Umoona Kidney Project

Summary

The Umoona Kidney Project was a program for the early detection, prevention and management of renal disease in the 400-strong Umoona community at Coober Pedy in the South Australia’s far north (850 kilometres from Adelaide). As part of this project, the DCA 2000 point-of-care instrument (Bayer Australia) was used on-site in the Aboriginal community setting for the first time in Australia. The DCA 2000 measures the albumin:creatinine ratio (ACR) on a drop (40 microlitres) of urine in 7 minutes; this test is a sensitive marker for early renal disease (microalbuminuria).

A voluntary risk assessment was conducted in 158 adults from the community. 24% of clients assessed had diabetes, 42% were hypertensive, while there was a large pool of incipient early and established renal disease (19% microalbuminuria and 9% macroalbuminuria).

A strong association was observed between blood pressure, BMI and glucose and the progression of albuminuria (as measured by the DCA). An association was also found between albuminuria and an increasing number of co-existing risk factors (with only 20% of people had a normal ACR in the presence of three or more risk factors).

35 adult members of the Umoona community were identified as either being at significant risk for renal disease or having established renal disease (previously undiagnosed). Through the use of an ACE Inhibitor, the renal and cardiovascular disease risk profiles of these people was significantly improved, and maintained for the following two years.

The risk assessment and clinical management arms of the Umoona Kidney Project ran concurrently with a series of continuing education and training sessions for Umoona's Aboriginal Health Workers about kidney disease, nutrition, and the use of the DCA 2000.

The project, which began in late 1997, was handed over to the community as a self-sustaining program, fully integrated into the Umoona Health service infrastructure in December 2000. Adoption of the Umoona model in other rural and remote Aboriginal communities in South Australia was recommended by the state-wide Iga Warta Renal Summit held in the Flinders Ranges in May 1999 and by the Department of Human Services' Implementation Plan for Renal and Urology Services 2000-2011.